SEMINAR ON

BURNOUT SYNDROME

BY,UMADEVI.K

IIND YEAR MSc NURSINGTHE OXFORD COLLEGE OF NURSING

BENGALURU

INTRODUCTIONBurn out is a psychological concept for the

experience of long term exhaustion and diminished interest (depersonalization) especially in work environment .Burn out usually occurs as a result of period of expending too much effort at work while having too little recovery .Health care workers are more prone to get burnout.High stress work can lead to burnout than low stress work. Burnout is an occupational hazard, especially in nursing. Compassion fatigue, bullying, chronic fatigue, weight gain and a host of other stress-related health challenges can result from unchecked stress and burnout.

BURNOUT SYNDROME(BOS)

BOS has been described as an inability to cope with emotional stress at work or as excessive use of energy and resources leading to feelings of failure and exhaustion. Although depression affects nearly every aspect of the person's life, symptoms of burnout occur only at work; however, BOS also decreases overall well-being

DEFINITION “Burnout is a syndrome made up of emotional

exhaustion, depersonalization, and reduced personal accomplishment “

(Beck, 1995)(OR)

An emotional condition marked by tiredness, loss of interest, or frustration that interferes with job performance. Burnout is usually regarded as the result of prolonged stress.

(Medical Dictionary) (OR)

“Burnout is a syndrome in which there is feeling of exhaustion,cynical attitude towards the job and people involved in job and through reduced personel accomplishment or work efficiency”

HISTORY

The term "burnout" originated in the 1940s, this word was used to describe when a jet engine stops operating at which the point it can no longer work. The word began to be used by humans in the 1970s, a "psychiatrist Herbert Freudenberger used the term to describe the status of overworked volunteers in mental health clinics. He compared the loss of idealism in these and he defined burnout as the progressive loss of idealism, energy, and purpose experienced by people in the helping professions as a result of the condition of their work"

STATISTICS The rates of stress and burnout among nurses have been found to

be higher than the rates among other health care professionals, with approximately 40% of hospital nurses having burnout levels that are higher than the morn of health care workers.

The prevalence of burnout is higher among nurses who work in

stressful settings, such as oncology, mental health, emergency and critical care

The rates of burnout among African American workers have been shown to be lower

Burnout is less prevalent among older individuals because they tend to be more stable and have a more balanced perspective on life

Family status plays an important role in burnout; rates of burnout are higher among single workers and workers with no children, due to the lack of support

What is the difference between burnout and depression?

Certain symptoms ascribed to burnout also occur in depression.These include

extreme exhaustion, feeling low, and reduced performanceSome characteristics of burnout are very different from those of

depression.These include alienation, especially from work. In depression, negative thoughts and feelings are not only about work, but about all areas of life. Other typical symptoms of depression are;

lack of self-esteem, hopelessness, and suicidal tendenciesThese are not regarded as typical symptoms of burnout. So not

every case of burnout will have depression at its root. But burnout symptoms may increase the risk of someone getting depression.

CAUSES

providing care around the clock patients becoming vulnerable and too needy health care constantly changing development of new technologies constant noise & business critical ill patients crisis of patients and family's (Cooper, 2001) work environment- work overload ( limited time,

resources, staff) demographic- young age, early in career, high level

of education personality- low self esteem, need for approval,

perfectionism, impatience

why does burnout occur?(risks)

JOB CHARACTERISTICS (excessive work load,scarcity ofresources,time pressure,role conflict)

OCCUPATIONAL CHARACTERISTICS (nurses,teachers,socialworkers)

FAMILIAL CHARACTERISTICS (family environment,responsibilities,familial demands)

INDIVIDUALS RISKS FOR BURNOUT

low self esteem competativeness excessive need for control higher job expectations and

satisfactions

NURSING SHORTAGE/BURNOUT CYCLE

Stages (According to alexander in 2009)

ACCORDING TO BURICSH IN 2006

FOUR STAGES OF BURNOUT SYNDROME STAGE I High stress,workload,job expectations STAGE II Physical and Emotional exhaustion  STAGE III Depersonalisation ,cynicism and

indifference STAGE IV Despair helplessness and aversion

BURN OUT SIGNALS

AFFECTIVE SIGNALS Depressed mood Changing mood Tearfulness Emotional exhaustion Tension and Anxiety

COGNITIVE SIGNALS sense of failure hopelessness, powerlessness poor self esteem guilt inability to concentrate PHYSICAL SIGNALS headache nausea dizziness ,muscle pain sleep disturbances ulcer chronic fatique

BEHAVIOURAL SIGNALS hyperactivity increased consumption of

tobacco,beverages abandonment of recreational

activities turnover absenteeism MOTIVATIONAL SIGNALS resignation dissapoinment boredom

SIGNS AND SYMPTOMS OF BURNOUT SYNDROME

Emotional exhaustion: People affected feel drained and exhausted, overloaded, tired and low, and do not have enough energy. Physical symptoms include pain or problems with the stomach or bowel.

Alienation from (job-related) activities: People affected find their jobs increasingly negative and frustrating. They may develop a cynical attitude towards their work environment and their colleagues. They may, at the same time, increasingly distance themselves emotionally, and disengage themselves from their work.

Reduced performance: Burnout mainly affects everyday tasks at work, at home or when caring for family members. People with burnout regard their activities very negatively, find it hard to concentrate, are listless and experience a lack of creativity.

OTHER SYMPTOMS : Frustration, fatigue, hypertension and depression.

HOW BURNOUT SYNDROME IS DIAGNOSED ?

 Various questionnaires can be used for

self-assessment (“Maslach Burnout Inventory” (MBI))

Assessing signs and symptoms and consulting doctor for confirmation

MBI (Maslach Burnout Inventory) 

Maslach and Jackson developed the Maslach Burnout Inventory (MBI) for detecting and measuring the severity of BOS. The scale evaluates three domains, namely,

emotional exhaustion depersonalization (negative or

cynical attitudes toward patients), and

loss of a feeling of personal accomplishment at work

MBI SCALE

HEALTH PROBLEMS RELATED TO BURNOUT

Stress related physical illness include: Heart disease, migraines, hypertension

Stress related mental health problems include: anxiety, depression, insomnia, and feelings of inadequacy

Nurses that are encountering ongoing stress are more likely to eat poorly, smoke cigarettes, use alcohol and drugs

All of these health related problems lead to negative health conditions affecting personal well being and subsequently, the quality and efficiency of patient care

COMPLICATIONS

Illness and disability Exhaustion Extinction of passion Mental breakdown Extreme depersonalization

MANAGEMENT APPROACHES

1.PERSON OR ORGANISATIONAL APPROACHES

PERSON DIRECTED ORGANISATIONAL DIRECTED COMBINED  PERSON DIRECTED psychotherapy counselling adaptive skill training communicative skill training social support exercises for relaxation

ORGANISATIONAL APPROACHES

training supervisors and managers changing organisational practices training for better coping and stress

management techniques change shift work system and

introducing vacations counselling and exercises

2.PSYCHOTHERAPEUTIC APPROACHES Group therapies like experimental

group therapy and group analytic therapy A)SYMPTOMATIC INTERVENTIONS physical relaxation techniques for fatique behavioural training for frustration social support identifying interesting areas and motivating B)ETIOLOGICAL INTERVENTIONS cognitive restructuring self contrl training training of active coping rational training for frustration

3.COPING STRATEGIES objectives coping oriented to problem coping oriented to emotion COPING METHODS ACTIVE COGNITIVE COPING (management

by assessing potential stressful events) ACTIVE BEHAVIOURAL COPING(observable

efforts managing stressful conditions) COPING BY AVOIDANCE( avoiding stressful

conditions and problematic situations)

PREVENTION Set boundaries with those around you or else

people will expect too much from you Keep a distinct balance between friends and

colleagues Do not allow family members to place

responsibility on you Make sure you are involved in a friendship where

both people are giving and taking an equal amount of social support from each other

Get a significant amount of sleep each night (8 hours), eat healthy and exercise

make full use of mentoring programs available within the workplace positioned toward new faculty, and help socializing between faculty to aid in sharing responsibility of humor

Self-renewal techniques must be implemented into daily routine

Renewal practices ultimately leads to increased energy, and enhanced self-worth feelings

Organizational engagements via institution leaders Self awareness - recognize the signs of stress

within yourself. Identify feelings, thoughts and behaviors you exhibit when under stress

Support - Share your concerns with empathetic family members, co-workers, and friends. If necessary seek professional counseling

Learn effective relaxation techniques that work for you, think positively, prioritize, set limits and develop a sense

conclusionBurnout syndrome (BOS) associated with stress

has been documented in health care professionals in many specialties.. In the health care organization, work stress may contribute to absenteeism and turnover, both of which detract from the quality of care. Hospitals in particular are facing a workforce crisis. The demand for acute care services is increasing concurrently with changing career expectations among potential health care workers and growing dissatisfaction among existing hospital staff. By turning toxic work environments into healthy workplaces, researchers and nurse leaders believe that improvements can be realized in recruitment and retention of nurses, job satisfaction for all health care staff, and patient outcomes—particularly those related patient safety.

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